<http://schema.org/articleBody>
"Michael Jackson&amp;#39;s Dermatologist and\\nFormer Plastic Surgeon Talk\\nDuring Michael Jackson's memorial service, the eulogies celebrated his brilliant showmanship, creativity, and dedicated parenting. But the montage running in the background told a parallel story of Jackson's metamorphosis from adorable child of obvious ethnicity to boy-man with an otherworldly visage.\\n\\n\\n\\nEveryone may have an opinion about the results of Jackson's epic transformation, but few understand the methods\u2014what exactly was required to achieve the constantly evolving looks. To answer that, we talked to the people who knew Jackson and his face best: Steven M. Hoefflin, his plastic surgeon through the 1980s and '90s, and about a dozen others with medical expertise or knowledge of his case.\\n\\n\\n\\nTheories abound about why Jackson chose to change so radically. One idea\u2014the most prevalent\u2014holds that Jackson suffered from a condition called body dysmorphic disorder (BDD), a loathing of one body part that no amount of surgery can cure. \\\"Michael viewed his nose like an anorexic views the body,\\\" says a Beverly Hills plastic surgeon. \\\"No matter how tiny his nose was, it was always too fat. He perceived it as opposite of what we saw.\\\" According to his dermatologist, Arnold Klein, however, Jackson was not immune to the often harsh criticism of the changes he made to his appearance.\\n\\n\\n\\nBDD may explain the nose, but it doesn't illuminate why Jackson gradually erased every vestige of his heritage, and much of his gender, with a host of procedures. Ultimately, that may be a question without an answer.\\nJackson falls and breaks his nose. This gives him an opportunity to change the feature he has come to detest, thanks to merciless teasing. He will later tell Oprah Winfrey, \\\"I'd hide my face in the dark.\\\" The results of Steven Hoefflin's surgery are visible on the *Off the Wall* album cover.\\nNoses sometimes can't be reduced all at once. \\\"It took a two-stage procedure,\\\" says Hoefflin. The process involves narrowing the nostrils, shaving internal cartilage, cutting out excess tissue in the tip, and supporting it\u2014sometimes with cartilage from behind the ear. The rounded tip is typical of Hoefflin's pea-pod graft. The results of the second stage (left) appear to indicate that the nose was made narrower and the tip less bulbous.\\nThough Jackson will later say at a news conference, \\\"I have never had cosmetic surgery on my eyes,\\\" his eyes look wider, with more of the white showing especially in the outer third and beneath the irises\u2014a result called scleral show. While some patients may consider this effect undesirable, a source close to Jackson believes he did in fact have the lower-eyelid surgery, and says, \\\"He liked the look.\\\"\\nAround this time, Jackson has another nose thinning, performed by a surgeon at the UCLA Medical Center. Jackson always maintained that he had had only two nose surgeries. One medical expert says, \\\"You can't look like that [what he looked like in 2009] with two rhinoplasties. He probably had 20.\\\" This may be semantics. With nose work, patients and doctors often don't count revisions as new procedures.\\nOn January 27, 1984, while he is filming a Pepsi commercial, a spark from fireworks ignites his hair, and Jackson suffers second-degree burns on his scalp. He loses a good deal of hair. Because of the accident, he has to wear wigs and hats, which become part of his signature look. Several years of scar revisions by Hoefflin follow. The incident may be what leads to Jackson's use of painkillers.\\nExperts say Jackson has his hairline, eyebrows, and eyelash lines tattooed, along with more nose thinning. The tattooing is apparently a necessity. Klein, his new dermatologist, diagnoses lupus, which causes rashes and hair loss, and vitiligo, causing blotchy loss of pigment. Vitiligo patients can lighten dark patches with a strong hydroquinone bleaching cream\u2014Jackson's choice, though he denies using it.\\nMany assume he is having continual nose surgery, but insiders believe he is instead having frequent injections of Kenalog, a steroid used to reduce scar tissue after surgery. Reduction of skin thickness is a side effect. The shots are painful, so it is common practice to sedate the patient with propofol (a.k.a. Diprivan), a fast-acting anesthetic. Jackson is said to have developed an affection for this drug as a sleep aid.\\nJackson has a stronger chin with a deep cleft, reportedly inspired by Kirk Douglas and installed by Hoefflin, and what seems like a smaller nose, perhaps the result of steroid injections. Jackson credits his new look to diet and lighting. The result is unsettling for many people because, as London cosmetic surgeon Jan Stanek theorized, the lower part of his face looks masculine while the eyes and nose look feminine.\\nJackson's skin tone here is much lighter, the result of skin-bleaching creams, pale makeup, or both. There is no sign of the blotchy pigment caused by vitiligo, but as a friend points out, \\\"You'll notice that Michael often wore long sleeves and military high collars to hide his neck.\\\" What he can't cover with clothing and wigs, he covers with makeup. The tip of his nose seems narrower, more pointed, and upturned.\\nAccording to Klein, Jackson was profoundly influenced by French mime Marcel Marceau. Here, they rehearse for an HBO special that never aired. There is a curious resemblance, though Marceau achieved the look with greasepaint.\\nBecause of the vitiligo and the regular bleaching, Jackson's skin is very sensitive to light. Hats, umbrellas, and sunglasses are his defense, though many think these are affectations. He often wears surgical masks in various colors, sometimes for their shock value and other times to hide fresh work on his face. His jaw looks strong enough to be a new, larger implant, but it could be the result of extreme weight loss.\\nThe gender confusion in Jackson's face does not end with changes to his eyes, nose, and chin. His lips, usually berry red with permanent makeup or lipstick, complete the picture. He seems to have had a subtle reduction of both upper and lower lips, which involves removing horizontal slivers of tissue from the mucosa, the inside edges. Ideally, the lower lip should be a third fuller and deeper than the upper. \\\"He liked to be different,\\\" says a friend.\\nMany people think Jackson's nose is falling off, or that he is wearing a prosthetic. The raggedness at the tip is actually paper tape, used by plastic surgeons to control swelling. It's customary for patients to wear it post-op for one week, day and night, then only at night. Jackson wears tape on his nose almost all the time, except when he is performing. \\\"Jackson's nose was never falling off,\\\" says one medical expert.\\nDespite the surgery, facial fillers, permanent makeup, skin-lightening creams, and lustrous wigs, Jackson is beginning to show his age. His long ordeal with accusations of child molestation (this was taken after a court appearance) may have played a role. By this time, Jackson's longtime plastic surgeon is out of the picture, and his dermatologist is mostly in charge of his care.\\nJackson's gaunt look reflects a loss of fat in the face. Klein has said he was using injections of Restylane, a temporary tissue filler, to build up some areas and even out others. Previous steroid injections in the nose have likely made the skin there so thin that the tissue-filling gel injected by Klein seems visible underneath. One expert says the indentation on the side of his nose may be from a recent skin-cancer biopsy."^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.allure.com/gallery/michael-jackson?slide=2>